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The measles epidemic continues to rage in the Pacific island nation of Samoa, where 5,267 people have been sickened and 73 have died, according to information released by the Government of Samoa on December 15, 2019. The majority of those who have died are infants and children under the age of 5.
The measles outbreak began in October of 2019, according to the Samoan government. Officials blame the outbreak on a steep decline in vaccination rates that occurred in 2018 after the death of two infants shortly after they received the measles, mumps, and rubella (MMR) vaccine.
Anti-vaccination activists were quick to blame the infant deaths on the MMR vaccine, but officials said they succumbed because nurses administering the vaccines accidentally mixed the doses with a muscle relaxant anesthetic instead of water. The Samoan government briefly suspended their vaccination program, but the public remained skeptical of the health system and many decided to forego vaccination, leaving the population vulnerable.
Health officials said the current measles outbreak is the direct result of reduced vaccination rates. Measles is a highly contagious vaccine-preventable illness, but the World Health Organization (WHO) notes that 95 percent of the population needs to receive two doses of the MMR to achieve so-called 'herd immunity' and protect against the illness. The Samoan government reports that 93 percent of the eligible population has been vaccinated against the measles as of December 15, 2019.
Samoan Governor Lolo M. Moliga declared a state of emergency in the country in mid-November, closing all public and private schools, early childcare centers, kindergartens, and daycares. The order cancels all public gatherings and urged village councils to enforce curfews. Travel into and out of the area is limited. On December 14, the government extended the state of emergency until December 29 at midnight.
The Samoan government instituted a mass vaccination on November 20, 2019. Officials say people at the highest risk for measles are children between the ages of 6 months to 19 years old and women between the ages of 20 and 35 years old who are not pregnant. Public health officials urge parents who have unvaccinated children 6 months of age or older to report to department of health clinics to get vaccinated. Officials also went door-to-door earlier in December to administer the MMR vaccine.
Samoa has a population of 200,000, and the measles outbreak affects a significant part of the population. Measles cases have also been reported in Tonga, New Zealand, and Fiji. International Emergency Medical Teams are helping to train health workers and care for those who are sick, according to WHO. Australia, New Zealand, the UK, Israel, and Hawaii are among the regions who have sent doctors, nurses, and public health officials to help in the aftermath of the outbreak.
The World Bank pledged $3.5 million dollars to aid in the Samoan measles emergency response and an additional $9.3 million dollars to bolster Samoa's health systems, according to the Samoan government.
"Measles is a highly contagious viral disease that can be fatal," according to MedicineNet authors Edmond Hooker, MD, DrPH, and Mary K. Bister, MD. The illness produces a fever above 101 degrees Fahrenheit, cough, runny nose, red eyes, and a generalized rash that lasts for more than 3 days. Two potential complications of the measles, pneumonia and inflammation of the brain (encephalitis), result in the most deaths from the illness.
"The only way to prevent measles is by receiving measles immunization," Hooker and Bister add. The current recommendation is for everyone to receive two doses of the MMR vaccine after 1 year of age.